August 20, 2008

Views of Disease Stir Controversy

Lyme disease is caught up in a swirl of confusion and controversy across the nation, and Oklahoma is no exception.

The controversy has arisen over disagreement about diagnosis, testing, treatment and prevalence of this complex disease.

Janet Segraves, facilitator for the Lyme Disease Support Group of Oklahoma, said the Oklahoma State Department of Health refuses to report hundreds of Oklahomans with Lyme disease to the U.S. Centers for Disease Control and Prevention.

"It has not always been this way in Oklahoma. Prior to 1999, the Department of Health reported to the CDC up to 110 cases of Lyme a year," she said.

Oklahoma health officials insist Lyme disease is uncommon in the state, and that many people who think they have Lyme actually have a similar, but less severe disease, called Southern Tick-Associated Rash Illness (STARI).

A patient's thoughts

Stacey Arnold of Oklahoma City, who was recently diagnosed with Lyme disease:

"I had no idea that a bacterial infectious disease could be considered controversial until I began discussing my test results with physicians. Apparently, some doctors are so adamant that Lyme disease doesn't exist here, that no amount of evidence would convince them otherwise.

"Keep in mind that there is a form of Lyme disease in Europe, and scientists think that an infected tick was carried across the Atlantic Ocean on a migratory bird. It defies all logic to then refuse to accept the possibility that borrelia (the bacteria that causes Lyme infection) couldn't find its way to Oklahoma.

"Our doctors are being told that there is no Lyme disease in Oklahoma, and in turn, they are telling their patients the same thing. Oklahoma has only three human cases reported since 2001, but somehow 533 reported cases in dogs. This just means that there are many more sick Oklahomans that are either misdiagnosed or undiagnosed."

(See http://dogsandticks.com/US-map-lyme-disease-dogs/ index.html)

The state's position

Dr. Kristy Bradley, state epidemiologist with the Oklahoma State Department of Health:

"Lyme disease is currently the most commonly reported tick-borne disease in the U.S., with more than 90 percent of cases reported from states in the Northeast, Upper Midwest and Pacific Coast regions of the country.

"In Oklahoma and other southern states where the incidence appears to be very low, some confusion and debate exists over the risk of acquiring Lyme disease in our geographical region.

"The Oklahoma State Department of Health investigates all reports from physicians and laboratories of patients who are found to have a positive screening test for Lyme disease. Our investigations have identified only three Western immunoblot confirmed cases of Lyme disease in Oklahoma since 2001. This suggests that the risk of true Lyme disease in Oklahoma is extremely low.

"The Oklahoma Animal Disease Diagnostic Laboratory identifies very few positive B. burgdorferi tests in dogs in comparison to ehrlichiosis and Rocky Mountain spotted fever. In my research of canine infections, I have found that their proportion of tick-borne illness diagnoses is consistent with the relatively low incidence of human Lyme disease in Oklahoma."